N-Terminal Probrain Natriuretic Peptide and C-reactive Protein in Stable Coronary Heart Disease

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• 作者：Gjin Ndrepepa ; Adnan Kastrati ; Siegmund Braun ; Julinda Mehilli ; Kathrin Niemö ; ller ; Nicolas von Beckerath ; Olga von Beckerath ; Wolfgang Vogt and Albert Schö ; mig
• 刊名：The American Journal of Medicine
• 出版年：2006
• 出版时间：April 2006
• 年：2006
• 卷：119
• 期：4
• 页码：355.e1-355.e8
• 全文大小：174 K

文摘

Purpose

C-reactive protein (CRP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) provide prognostic information in patients with stable coronary heart disease. The aim of the study was to investigate whether combined use of NT-proBNP and CRP improves risk stratification in these patients.

Methods

This cohort study included 989 patients with stable coronary heart disease who underwent coronary stenting. CRP and NT-proBNP were measured before angiography. The primary end point of the study was all-cause mortality. Using median values of NT-proBNP (279.9 ng/L) and CRP (1.2 mg/L), patients were divided into 4 groups: low NT-proBNP-low CRP group (305 patients with NT-proBNP<median and CRP<median); low NT-proBNP-high CRP group (190 patients with NT-proBNP<median and CRP≥median; high NT-proBNP-low CRP group (237 patients with NT-proBNP≥median and CRP<median); and high NT-proBNP-high CRP group (257 patients with NT-proBNP≥median and CRP≥median).

Results

During a median follow-up of 3.6 years (interquartile range 3.3 to 4.5 years), there were 85 deaths: 6 deaths in the low NT-proBNP-low CRP group, 11 deaths in the low NT-proBNP-high CRP group, 20 deaths in the high NT-proBNP-low CRP group, and 48 deaths in the high NT-proBNP-high CRP group with Kaplan-Meier mortality estimates of 2.7 % , 8.9 % , 12.1 % and 35.6 % , respectively (P <.001). Cox proportional hazards model showed that combination NT-proBNP-CRP was the strongest independent correlate of mortality (hazard ratio [HR] 4.3, 95 % confidence interval [CI], 2.0-9.3; P <.001 for high NT-proBNP-high CRP vs low NT-proBNP-low CRP).

Conclusion

Combined use of NT-proBNP and CRP improves long-term risk prediction of mortality in patients with stable coronary heart disease.